Provider Demographics
NPI:1518361088
Name:BUGARIN, TAMMY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BUGARIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 PROFESSIONAL DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-3949
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:607 PROFESSIONAL DR
Practice Address - Street 2:SUITE #2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3949
Practice Address - Country:US
Practice Address - Phone:406-600-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT643-LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical